The World Bank pioneered global HIV and AIDS financing early in the emergency and remains committed to achieving Millennium Development Goal 6, to halt by 2015 and begin to reverse the spread of HIV and AIDS, through prevention, care, treatment, and mitigation services for those affected by HIV and AIDS.
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Argentina reduced its HIV/AIDS burden by
21 percent from 2000 to 2010, saving an estimated 4,379
lives. This makes Argentinas HIV/AIDS burden the second
lowest in ... Show More +South America after Chile. Argentina reduced the
mother-to-child HIV/AIDS transmission rate by 62 percent
from 2000 to 2011. The National HIV/AIDS Program was created
in 1995 and has since introduced key innovations that have
contributed to the reduction of the HIV/AIDS burden in
Argentina. As of 2010, the National HIV/AIDS Program is
entirely domestically funded, and a World Bank study has
found the Program to be cost-beneficial. Show Less -

Argentina reduced its HIV/AIDS burden by
21 percent from 2000 to 2010, saving an estimated 4,379
lives. This makes Argentinas HIV/AIDS burden the second
lowest in ... Show More +South America after Chile. Argentina reduced the
mother-to-child HIV/AIDS transmission rate by 62 percent
from 2000 to 2011. The National HIV/AIDS Program was created
in 1995 and has since introduced key innovations that have
contributed to the reduction of the HIV/AIDS burden in
Argentina. As of 2010, the National HIV/AIDS Program is
entirely domestically funded, and a World Bank study has
found the Program to be cost-beneficial. Show Less -

Jamaica has made many notable
achievements in the fight against HIV/AIDS, which include a
robust treatment program and improved HIV prevention
programs that increas... Show More +ingly focus on the key drivers of the
HIV epidemic and which are based on evidence. These
attainments have resulted in a sustained decline in the
estimated incidence of HIV and in a reduction in AIDS
mortality. The national response to HIV/AIDS in Jamaica is
currently financed by the Government as well as by several
external sources, including the World Bank, the Global Fund
to Fight AIDS, Tuberculosis and Malaria (Global Fund) and
the United States government. It is expected, however, that
external financing will cease or be significantly reduced in
the next two years. As a result, a substantial increase in
domestic financing for the national HIV/AIDS response will
be needed. However, public debt levels are high, and the
country is feeling the repercussions of the global financial
crisis, thus the availability of domestic resources is and
will be very tight. Any shortfall in financing whether
domestic, external or both will have serious implications
for the delivery of HIV services. The Government of Jamaica
requested this study so as to inform its future HIV/AIDS
policy response. This study is one input in a series of
actions that the Government will undertake to formulate a
future sustainability plan and investment framework for the
National HIV Program. This study was led and financed by the
World Bank and conducted in collaboration with the
Government of Jamaica and United Nations Programme on
HIV/AIDS (UNAIDS). The study aimed to assess the
sustainability of Jamaica's National HIV Program from a
fiscal perspective. Specifically, the purpose of the study
was to: 1) review current spending on HIV/AIDS and the
sources of financing; 2) estimate the fiscal burden of the
national HIV/AIDS response and assess the outlook for
external financing of the HIV program; 3) project how the
epidemic will unfold as well as what the costs would be
under different potential scenarios; and 4) provide
recommendations to inform policy decisions. Show Less -

This study on the implementation
efficiency of the HIV/AIDS national response in Colombia
seeks to examine how it has been implemented -- whether it
has been done a... Show More +ccording to the available evidence about the
epidemic and as the response was originally planned. The
study approaches three specific dimensions of implementation
efficiency: (i) programmatic; (ii) budgetary; and (iii)
service delivery. The study uses a range of research
techniques, including: (i) documentary analysis of key
policies, official publications and reports; (ii)
semi-structured interviews with representatives of the
central government and territorial entities, international
and community-based organizations, insurers, care providers,
etc.; and (iii) case-study analysis to visualize the ways in
which people are cared for in practice. The available data
suggest that the HIV/AIDS response is succeeding in keeping
the prevalence low and the epidemic concentrated. In recent
years, the level of health coverage has increased and the
quality of care services has improved. The identified
problems in service delivery (mostly related to coverage and
access) are linked to system fragmentation and integration,
and to the nature of the coordination mechanisms, both at
the national and the territorial level. The effectiveness of
the response would benefit from re-energized leadership at
both the national and local levels -- articulated through
the existing programmatic framework and coordinating
mechanisms. The complexity of the system and the lack of
budgetary and expenditure information have impeded the
evaluation of the budgetary efficiency of the HIV/AIDS response. Show Less -

Evidence is crucial in strategic
planning for HIV response as well as the monitoring of
results. This paper presents a simple tool that can be used
to analyze the m... Show More +ethodological quality of HIV data, its scope
and limitations, and whether it can be accurately compared
with other evidence. The tool, utilized as a questionnaire
or checklist, first identifies the type of document
containing the data; the status and means of its
publication; the epidemiological design used; and the
priority population. Next, the document is analyzed against
a verification list based on eight methodological criteria:
1) objective; 2) inclusion and exclusion criteria; 3) sample
size; 4) sampling technique; 5) error-reduction strategies;
6) data analysis technique; 7) limitations; and 8)
confidence intervals and/or statistical significance. The
paper also presents the results of implementing the tool in
three Latin American countries. Show Less -

Evidence is crucial in strategic
planning for HIV response as well as the monitoring of
results. This paper presents a simple tool that can be used
to analyze the m... Show More +ethodological quality of HIV data, its scope
and limitations, and whether it can be accurately compared
with other evidence. The tool, utilized as a questionnaire
or checklist, first identifies the type of document
containing the data; the status and means of its
publication; the epidemiological design used; and the
priority population. Next, the document is analyzed against
a verification list based on eight methodological criteria:
1) objective; 2) inclusion and exclusion criteria; 3) sample
size; 4) sampling technique; 5) error-reduction strategies;
6) data analysis technique; 7) limitations; and 8)
confidence intervals and/or statistical significance. The
paper also presents the results of implementing the tool in
three Latin American countries. Show Less -

This paper summarizes the key findings
of an 'After Action Review' (AAR) that reflects a
decade of experience in designing and implementing ten
HIV/AIDS projects in... Show More + the Caribbean, financed by the World
Bank. The objective is to identify what worked (and what
didn't) in the project approach, design and
implementation, distilling useful lessons for other projects
in small states. Show Less -

The guiding principles of this work
program are to: (i) promote sectoral leadership; (ii)
strengthen work at the national level; (iii) further develop
the Caribbean... Show More + community education sector HIV/AIDS
coordinator network; and (iv) ensure that processes are
responsive to Task Team Leaders (TTLs) in the regions. The
work is demand-led, and will focus on dialogue at the
country level with both government and development partners.
All work is conducted within the scope of operational work
plans, supporting the regions through participation in the
joint review of projects and working directly on SWAPs with education. Show Less -

Recent studies point to a number of
current and emerging concerns in the health and nutrition of
school-age children in the Caribbean region. Critical among
them ar... Show More +e: infectious diseases including HIV and other
sexually transmitted infections (STIs); non-communicable
diseases (NCDs); and violence. Common health conditions
including diabetes, hypertension and heart disease in the
adult population can be positively linked to unhealthy
lifestyles in youth. These health challenges, combined with
a large school-age population, which in some countries may
be a sizable third of the overall population, make a strong
national response to the health and nutritional needs of
school-age children particularly vital. As lifelong patterns
of behavior and thinking are established during youth, it is
critical to ensure early and widespread promotion of healthy
practices related to sexual behavior, nutrition and a
healthy lifestyle in general in the school-age population,
resulting in a healthier adult population in the future. The
rapid survey and this resulting report contribute to the
collection of locally relevant evidence, as well as regional
information relevant to School Health and Nutrition (SHN)
and HIV, to build a sound evidence base at both country and
regional levels to inform policy and strategy. It has
further application as a resource for knowledge sharing as
it provides a comparative perspective on activities and
initiatives thus far implemented throughout the Caribbean
region, and on the allocation and mobilization of resources
used to support these activities and initiatives. Show Less -

This report is the result of a
comprehensive, regional, data-driven review of the HIV
epidemic in the Caribbean. Several reports have been
published about the Carib... Show More +bean but none have specifically
focused on a thorough review of data sources, data
collection strategies and detailed epidemiology of the HIV
epidemic. In the past, the Caribbean epidemic has largely
been characterized as a generalized, heterosexual epidemic
on the verge of explosion. The purpose of an HIV
epidemiological synthesis is to assess and analyze new or
recent data to provide strategic direction for the program
development and implementation. New data sources include any
unpublished, unexplored or unanalyzed data, the latest
surveillance data, as well as, biological and behavioral
surveys, STI data, program monitoring data and quantitative
or qualitative research data. The synthesis also tests and
explores an existing hypothesis about the epidemic and
discusses relevant data-based policy implications. For the
Caribbean synthesis, aimed to: 1) analyze HIV transmission
patterns; 2) determine epidemiological and behavioral
drivers in the Caribbean; and 3) analyze the national and
regional responses relative to findings from the analysis. Show Less -

A rapid situation analysis of the
education sector's response to HIV and AIDS in Guyana
was undertaken between October and November 2007. The
analysis was supported... Show More + by United Nations Educational,
Scientific, and Cultural Organization (UNESCO), the World
Bank, and the Partnership for Child Development (PCD) as
part of ongoing efforts to support the call of the Caribbean
Community (CARICOM) ministers of education for continuing
dialogue and action towards accelerating the education
sector response to HIV and AIDS in the Caribbean. The
situation analysis sought to enable the development of a
comprehensive school health, nutrition, and HIV education
sector response for incorporation within the forthcoming
Guyana education sector strategic plan, 2008-12. The conduct
of the analysis sought to reflect the wishes of the
Government of Guyana; the recommendations of previous
UNESCO, World Bank, and PCD missions; and internationally
agreed best practice that education sector responses to HIV
should be a fundamental component of an integrated and
holistic program of school health and nutrition activities.
The situation analysis also sought to contribute to a
stronger presence of the education sector in the Government
of Guyana's multisectoral response to HIV and AIDS, as
outlined in the Guyana national HIV and AIDS strategy 2007-11. Show Less -

Saint Lucia has achieved some notable
successes in its HIV response. But more could be done to
protect the welfare, safety and security of children whose
lives are ... Show More +affected by HIV and AIDS. This note suggests key
legal reforms - including some "Quick Wins" - that
could contribute to improving the legal protection of
children in Saint Lucia who are orphaned or made vulnerable
by AIDS. Show Less -

Saint Vincent and the Grenadines has
achieved some notable successes in its HIV response. But
more could be done to protect the welfare, safety and
security of chil... Show More +dren whose lives are affected by HIV and
AIDS. This note suggests key legal reforms - including some
"Quick Wins" - that could contribute to improving
the legal protection of children in Saint Vincent and the
Grenadines who are orphaned or made vulnerable by AIDS. Show Less -

The HIV/AIDS epidemic is a major health
crisis for the Caribbean. According to the latest
indicators, the Caribbean is the second most affected area
of the world, s... Show More +econd only to Sub-Saharan Africa. It is clear
that in at least several Caribbean countries, HIV/AIDS has
spread beyond a concentrated epidemic tied to high-risk
groups into a generalized epidemic impacting the greater
population. Approximately 440,000 people are currently
living with HIV in the Caribbean and, of these, 53,000
acquired the virus in 2004. In the Caribbean Community
(CARICOM) countries specifically, 370,000 people are
currently living with HIV, with 48,000 of them having
acquired the virus in 2004. Show Less -

The government has invested heavily in
the prevention and treatment of human immunodeficiency virus
(HIV) and acquired immunodeficiency syndrome (AIDS) and
other se... Show More +xually transmitted diseases (STDs), targeting groups
most at risk, and offering antiretroviral treatment - free
of charge -to all identified patients who qualify for it. In
recent years, the epidemic has been spreading to women,
poorer groups, and towards the interior of the country. In
May 2010, the World Bank approved a United States (U.S.) 67
million dollars loan to Brazil, in support of the federal
AIDS- Brazil's unified health system (SUS) project,
aiming at increasing prevention, care, and treatment
services for groups most at risk of HIV and AIDS and STDs.
The project will also support the governments efforts to
improve health program performance through improved
governance, decentralization, and results-based management.
The project will also map the epidemic and the health
response for groups most at risk by region. Show Less -

The government has invested heavily in
the prevention and treatment of human immunodeficiency virus
(HIV) and acquired immunodeficiency syndrome (AIDS) and
other se... Show More +xually transmitted diseases (STDs), targeting groups
most at risk, and offering antiretroviral treatment - free
of charge -to all identified patients who qualify for it. In
recent years, the epidemic has been spreading to women,
poorer groups, and towards the interior of the country. In
May 2010, the World Bank approved a United States (U.S.) 67
million dollars loan to Brazil, in support of the federal
AIDS- Brazil's unified health system (SUS) project,
aiming at increasing prevention, care, and treatment
services for groups most at risk of HIV and AIDS and STDs.
The project will also support the governments efforts to
improve health program performance through improved
governance, decentralization, and results-based management.
The project will also map the epidemic and the health
response for groups most at risk by region. Show Less -

The Caribbean Region has the highest HIV
prevalence in the world outside Africa. An estimated 440,000
individuals are HIV positive or a mean prevalence rate of
2.3 ... Show More +percent for adults aged 15 to 49, with a range from 1.5
to 4.1 percent. AIDS is the leading cause of death in that
age group. There is still little hard evidence on the
HIV/AIDS epidemic and considerable uncertainty about its
possible future course. The epidemic remains hidden from
view, due in large part to strong stigma and discrimination
within the Region. In some countries HIV/AIDS is considered
a health threat but not a major development threat despite
its potential impact on their economies. National HIV/AIDS
programs are primarily focused on the health sector
response. Treatment is being scaled up with less attention
being paid to prevention and care, to the multi-sector
response and the meaningful engagement of civil society. For
most countries, national strategies, monitoring and
evaluation systems and organizational and governance
structures are weak. This is not due to a lack of political
will but to weak institutional and human capacity. The
HIV/AIDS review team recommends that priority attention for
the national response should include (1) restoring a
strategic balance in national programs with intensified
focus on prevention, (2) launching a concentrated attack on
stigma and discrimination through better analysis
communication strategies and legal action, (3) adopting
simple, low-tech monitoring and evaluation systems to
support interventions based on evidence, (4) enhancing local
capacity through innovative, collaborative means rather than
increases in numbers of staff, and (5) simplifying
implementation processes, especially for smaller states. The
Regional response should be invigorated by improving the
capacity of the Pan Caribbean Partnership Against HIV/AIDS
(PANCAP) and other regional agencies to coordinate the
regional response and to serve national programs more effectively. Show Less -

The objectives of this study are to: (a)
assess the impact of the World Bank's Human
Immunodeficiency Virus (HIV)/Acquired Immunodeficiency
Syndrome (AIDS) assistan... Show More +ce to Brazil relative to the
counterfactual of no Bank assistance; and (b) distill
lessons for future HIV/AIDS activities. It is one of four
case studies included in a larger evaluation by the
Operations Evaluation Department (OED) of the World Bank,
which aims to assess the development effectiveness of
country-level World Bank HIV/AIDS assistance. The findings
reflect the situation through the end of 2003, shortly after
the field visit of the evaluation team. The evaluation has
also highlighted numerous lessons from the Bank's
engagement with Brazil on AIDS: the need to foster political
commitment at all levels of policy formulation and
implementation; the Bank's role in lending legitimacy
to controversial prevention programs; the need to address
constraints in the health system that are critical to the
AIDS response; opportunities for the Bank to invest in
public goods that improve the efficiency of treatment; the
critical contribution of Non-governmental organization (NGO)
involvement in terms of reaching high-risk groups, but the
need to invest in implementation capacity to make sure this
happens; concerns about the long-run sustainability of the
NGO response that is dependent on Bank-sponsored projects;
the need to incorporate adequate preparation and incentives
for monitoring and evaluation into projects; and the
feasibility of working with high-risk groups in a
concentrated epidemic when interventions are developed by
and with communities at risk and respecting their human rights. Show Less -

The Pan-Caribbean Partnership against
HIV/AIDS (PANCAP) was designated an 'international best
practice' by the Joint United Nations Program on
HIV/AIDS (UNAIDS). A ... Show More +case study on the Pan-Caribbean
Partnership against HIV/AIDS (PANCAP) in December, 2004. The
Caribbean region is second only to Sub-Saharan Africa in HIV
prevalence with an estimated adult HIV prevalence rate of
2.3 percent in 2003. Approximately 430,000 adults and 23,000
children are living with HIV in the region. HIV/ AIDS are
the leading cause of death among adults in the age group
15-44 years. The epidemic is not just a health problem, but
a developmental and economic problem as it affects the most
productive human resources and redirects efforts from
productive activities to HIV/AIDS treatment and care. A
number of lessons emerge from PANCAP's experience. The
building of the partnership was regionally led and owned. En
Breve is proud to present the HIV/AIDS series which will run
from January until June of 2005. The series looks to raise
awareness on how HIV/AIDS directly affects the overall
development of the region focusing on the Caribbean. Show Less -